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Validation of the Problematic Khat Use Screening Test: A Cross-Sectional Study.

Awoke Mihretu1, Abebaw Fekadu1,2,3, Sam Norton4

  • 1Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

European Addiction Research
|March 30, 2022
PubMed
Summary

The Problematic Khat Use Screening Test (PKUST-17) is a reliable tool for identifying khat use severity in Ethiopia. This screening test aids in providing appropriate stepped care for individuals with mild, moderate, or severe problematic khat use.

Keywords:
EthiopiaItem response theoryKhat useLatent profile analysisProblematic khat usePsychometric propertiesValidation

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Area of Science:

  • Psychometric evaluation of screening tools
  • Substance use disorder research
  • Mental health screening in primary care

Background:

  • Khat use is prevalent in Ethiopia, necessitating validated screening tools.
  • Assessing problematic khat use is crucial for timely intervention and care.
  • Existing screening tools may lack cultural appropriateness or psychometric validation in diverse populations.

Purpose of the Study:

  • To evaluate the psychometric properties of the Problematic Khat Use Screening Test (PKUST-17) in an Ethiopian population.
  • To assess the construct validity, internal consistency, and convergent validity of the PKUST-17.
  • To identify distinct latent classes of problematic khat use.

Main Methods:

  • A validation study involving 510 khat users in Ethiopia using a house-to-house survey.
  • Confirmatory factor analysis and 2-parametric item response theory (IRT) for construct validity.
  • Spearman's rank-order correlation for convergent validity with depression and functional impairment.
  • Latent profile analysis (LPA) to identify severity classes of problematic khat use.

Main Results:

  • The PKUST-17 demonstrated a robust unidimensional structure with excellent internal consistency (Cronbach's alpha = 0.93).
  • IRT analysis confirmed strong item discrimination and appropriate difficulty thresholds.
  • Latent profile analysis identified three distinct classes: mild (34%), moderate (34%), and severe (32%) problematic khat use.
  • Higher severity classes were significantly associated with depression symptoms and functional impairment.

Conclusions:

  • The PKUST-17 is a psychometrically sound, culturally appropriate, and user-friendly screening tool for problematic khat use in Ethiopia.
  • The test effectively differentiates individuals across a spectrum of khat use severity, enabling stepped care approaches.
  • Findings support the integration of PKUST-17 into primary healthcare for early identification and management of problematic khat use.